No abstract available.
Anterior Cruciate Ligament* ; Magnetic Resonance Imaging*

No abstract available.
Magnetic Resonance Imaging*

OBJECTIVE: Recently, selective termination is employed in multifetal pregnancies, in the presence of an abnormal fetus, or in the complication of twin pregnancies. The purpose of this study is to evaluate effectiveness, safety of the tailored selective termination in multifetal pregnancies. METHODS: This study was retrospective and involved six cases. Indication of termination were 3 cases of structural anomalies (anencephaly, encephalocele, body stalk anomaly), 1 case of chromosomal anomaly (21 trisomy) and 2 cases of monochorionic twin complications (acardiac twin, twin to twin transfusion syndrome). RESULTS: We used KCL injection in 4 cases, they were all confirmed dichorionic twin, and in 2 cases of monochorionic twin, we used alcohol ablation of intra-abdominal umbilical artery in 1 case, and radiofrequency ablation of the cord in 1 case. CONCLUSION: All procedures were successful, and all normal infants were delivered in 3rd trimester. Tailored selective termination in 2nd trimester is effective and safe in abnormal multifetal pregnancies.
Catheter Ablation ; Encephalocele ; Female ; Fetofetal Transfusion ; Fetus ; Humans ; Infant ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy, Twin* ; Retrospective Studies ; Umbilical Arteries

BACKGROUND: Atherosclerotic cardiovascular disease and metabolic syndrome are both rapidly increasing in Koreans due to the new westernized eating habits and the aging of the population. The pulse wave velocity (PWV) reflects arterial stiffness and it may be used as an indicator of atherosclerosis. This study was conducted to investigate the association of the PWV with metabolic syndrome. METHODS: Among 1438 persons who visited the Internal Medicine Clinic or Health Center of a general hospital in Seoul, Korea, 384 adults (age range: 30-69 years old) were selected as study subjects. Those patients with cardiovascular disease or other systemic disease were excluded, but the patients with hypertension and diabetes mellitus were included. Ninety four (25.4%) subjects were classified as patients with metabolic syndrome when jointly applying the WHO Asia-Pacific criteria and NCEP ATPIII criteria. RESULTS: The PWV was higher in the older aged group and in the men compared to the other group. The greater the number of diagnostic criteria of the metabolic syndrome subjects had, the higher was their PWV. After adjustment for age, gender, blood pressure, BMI and fasting blood glucose, a PWV change of 1.0 m/sec increased the risk of metabolic syndrome by 1.31 times (95% CI: 0.81-2.09). The risk of metabolic syndrome was 7.62 times higher among the subjects with a PWV greater than 7.5 m/sec (95% CI: 1.07-54.42), as compared with that of subjects with a PWV less than 7.5 m/sec. CONCLUSIONS: The PWV may independently increase the risk of metabolic syndrome as a non-linear pattern. A prospective study needs to be conducted to confirm the meaning of PWV as a risk factor for metabolic syndrome, and especially to determine the cut off point.
Adult ; Aging ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Diabetes Mellitus ; Eating ; Fasting ; Hospitals, General ; Humans ; Hypertension ; Internal Medicine ; Korea ; Male ; Prospective Studies ; Pulse Wave Analysis* ; Risk Factors ; Seoul ; Vascular Stiffness

OBJECTIVES: To evaluate characteristic computed tomography (CT) and magnetic resonance (MR) imaging findings of granulocytic sarcomas of the head and neck. METHODS: The CT (n=11) and MR (n=1) images obtained from 11 patients (7 males and 4 females; mean age, 23.5 yr; age range, 1 to 69 yr) with histologically-proven granulocytic sarcomas of the head and neck were retrospectively reviewed. Histological confirmation was done by bone marrow biopsy in 9 patients, and/or local biopsy in 4 patients. The imaging findings were analyzed with particular attention to location, size, shape, margin, bone destruction, internal architecture, pattern and degree of enhancement, and multiplicity of the lesions. RESULTS: The masses were most commonly located in the orbital cavity (n=8); other locations included lymph nodes (n=5) and palatine/pharyngeal/lingual tonsils (n=3). The mass sizes varied from a mean diameter of 1.3 to 5.8 cm (average, 2.6 cm). Multiple lesions were found in 6 patients. The shapes of the tumors were ovoid in 12 patients and irregular in 4 patients. Most lesions had poorly-defined margins (13/16) and invaded adjacent bony structures (5/16). On the pre-contrast CT images, the masses were iso- (5/8) or low-density (3/8) in comparison with muscle. The MRI, which was obtained in one patient in this study, showed that the mass was iso-signal intensity on T1-weighted images and iso-signal intensity on T2-weighted images compared to the gray matter of the brain. On the post-contrast CT images, there was homogenesous (n=12) or heterogeneous (n=4) enhancement, with mild (n=10), moderate (n=4), and marked (n=2) enhancement in the solid portions of the lesions. CONCLUSION: Although rare, granulocytic sarcomas arise in various locations in the head and neck area (most commonly in the orbit) in the form of well-demarcated, and mildly- and homogenously-enhancing masses with adjacent bony invasion.
Biopsy ; Bone Marrow ; Brain ; Head ; Humans ; Lymph Nodes ; Magnetic Resonance Spectroscopy ; Male ; Muscles ; Neck ; Orbit ; Palatine Tonsil ; Retrospective Studies ; Sarcoma, Myeloid

No abstract available.
Douglas' Pouch* ; Stomach Neoplasms*

BACKGROUND: In Korea, methicillin-resistant Staphylococcus aureus (MRSA) is the most common nosocomial pathogen, which is particularly prevalent in ICU. We performed this study to investigate the modes of transmission of MRSA and the role of nasal carriage of11RSA to subsequent MRSA infections in medical ICU. METHODS: All patients admitted to the medical lCU during 10 months were studied prospectively. Nasal swabs were done in all patients within 24 hours of admission and weekly thereafter. For patients who developed MRSA infections, additional cultures were done before start of antibiotics. Surveillance cultures of nostril, hands of health care workers and environment were done once at the end of the study. Bacterial typing was performed with pulsed-field gel electrophoresis (PFGE) using Smal. RESULTS: Among 138 patients enrolled, 24 patients (17.4 %) were nasal colonizers, and 9 patients (6.5%) were already infected with MRSA prior to admission. New nasal colonization among patients, in whom follow up nasal cultures were done at the interval of 3 days or more, developed at 36.2 % (21/58 patients). New infections of MRSA in patients who were admitted for more than 3 days, developed at 11.7 % (13/111 patients). Patients in isolation room were infected with MRSA less frequently (P <0.05). No other risk factors for nasal colonization of MRSA or MRSA infections were found. There were no significant differences between nasal colonizers and non-colonizers in the incidence of MRSA infections. PFGE analysis of MRSA isolates from patients showed several major patterns, which were similar in both MRSA isolates obtained prior to admission and those acquired after admission. PFGE patterns of MRSA isolates from health care workers and environment were different from those of patients. CONCLUSION: Patients who were infected or colonized with MRSA seemed to be a major source for transmission of MRSA in medical ICU. In medical lCU, where MRSA were prevalent, nasal colonization was not related to the increased incidence of MRSA infections.
Anti-Bacterial Agents ; Bacterial Typing Techniques ; Colon ; Cross Infection ; Delivery of Health Care ; Electrophoresis, Gel, Pulsed-Field ; Follow-Up Studies ; Hand ; Humans ; Incidence ; Intensive Care Units ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prospective Studies ; Risk Factors ; Staphylococcus aureus

Lung adenocarcinoma is the cancer originated in terminal bronchiole or alveolar epithelium and its incidence is on the increase. The most common radiologic pattern of lung adenocarcinoma is peripheral nodule or mass, but it can be showed various findings such as hilar mass, consolidation, atelectasis or multicentric lesions. Sometimes it is difficult to differentiate lung adenocarcinoma from other diseases, especially pneumonia. We experienced three patients with lung adenocarcinoma, just only presented as pneumonic consolidation on chest X-ray and CT scan. The clinician should consider seriously lung adenocarcinoma including bronchioloalveolar carcinoma in patients who did not respond to antibiotics. And in such cases, pathologic diagnosis must be perfomed at proper time to confirm disease.
Adenocarcinoma* ; Adenocarcinoma, Bronchiolo-Alveolar ; Anti-Bacterial Agents ; Bronchioles ; Diagnosis ; Epithelium ; Humans ; Incidence ; Lung* ; Pneumonia ; Pulmonary Atelectasis ; Thorax ; Tomography, X-Ray Computed

BACKGROUDN: In end-stage renal disease (ESRD) patients, cardiovascular disease (CVD) is a major cause of morbidity and mortality. These patients frequently have hyperhomocysteinemia, a putative risk factor for cardiovascular disease. Several studies suggest that lowering plasma homocysteine may improve endothelial dysfunction, a marker of atherothrombotic risk. Pulse wave velocity (PWV) is a useful diagnostic tool to access endothelial dysfunction, and is widely used screening test for atherosclerosis. METHODS: We measured fasting total plasma homocysteine (tHcy) in 84 hemodialysis patients and 21 peritoneal dialysis patients. Subjects were assigned to two groups. Group I (tHcy <20 umol/L) consisted of 74 ESRD patients who have taken continual usual dose folate (1 mg/day). Group II (tHcy> or =20 umol/L) consisted of 26 ESRD patients who have taken high dose folate (5 mg/day). For 15 Group I patients and 5 Group II patients, pulse wave doppler velocity (PWV) measurements were taken before and after 3 months of folate treatment. RESULTS: The mean tHcy concentration was higher in the ESRD patients (82 HD: 16.9+/-6.4 mol/L, 20 PD: 18.0+/-16.7 mol/L). The pulse wave velocity (PWV) was faster in ESRD patients-19 HD: Aorta (Ao)-PWV 8.98+/-1.4, lower extremities (LE)-PWV 10.15+/-1.3, upper extremities (UE)-PWV 8.80+/-0.8 (m/s); 8 PD: Ao-PWV 9.32+/-1.8, LE-PWV 10.64+/-1.4, UE-PWV 9.24+/-0.7 (m/s). The PWV increased in ESRD patients with coronary heart disease and who had a history of angioplasty because of thrombosis or stenosis of vascular access. There was a significant reduction in hyperhomocysteinemia after 3 months in the high dose folate supplement group as compared to the usual dose folate supplement group with a significant statistical difference between the two groups. (15 Group I patients: 13.9+/-4.9 mol/L->13.5+/-6.1 for 5 Group II patients: 34.3+/-27.5 mol/L->23.0+/-5.9 mol/L (p<0.05, paired t-test). No difference in the PWV was found before and after folic acid supplementation for the two groups (p>0.05, paired t-test). CONCLUSIONS: We assume that PWV and homocysteine concentration have some correlation and both studies are available as part of screening tests for atherosclerosis in ESRD. Although no significant interval change was detected for the PWV, this finding suggests that high-dose folate supplementation was helpful to minimize the risk of cardiovascular disease associated with hyperhomocysteinemia in ESRD patients.
Angioplasty ; Aorta ; Atherosclerosis ; Blood Flow Velocity ; Cardiovascular Diseases ; Constriction, Pathologic ; Coronary Disease ; Fasting ; Folic Acid* ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Kidney Failure, Chronic* ; Lower Extremity ; Mass Screening ; Mortality ; Peritoneal Dialysis ; Plasma ; Pulse Wave Analysis* ; Renal Dialysis ; Risk Factors ; Thrombosis ; Upper Extremity

No abstract available.
Immunotherapy*